- Highmark Health (Little Rock, AR)
- …Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN … more
- Humana (Little Rock, AR)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… more
- Humana (Little Rock, AR)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
- Humana (Little Rock, AR)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- Guardian Life (Little Rock, AR)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Sedgwick (Little Rock, AR)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
- Catholic Health Initiatives (Little Rock, AR)
- …CCM or ACM Certification within 2 years of hire date + Previous case management , utilization management , or discharge planning experience strongly preferred ... **Overview** As a ** RN Case Manager** with CHI St Vincent Infirmary,...CHI St Vincent Infirmary, you'll work with physicians, other registered nurses, specialized departments, and community resources. This provides… more
- Arkansas Children's (Little Rock, AR)
- …clinic as a genetic counselor a portion of the time. He/she will screen and review all orders for genetic tests whether performed in-house or sent to a reference ... In addition, he/she will participate in collaborative efforts to improve utilization , quality, and reimbursement for the laboratory. Experience is desirable but… more